Story TOpics

Six years ago, the Iowa Department of Human Services was put on notice by the federal government that a West Des Moines company called Ultimate Nursing Services of Iowa appeared to be improperly billing Medicaid for a large portion of the home health care services it provided Iowans.

In response, DHS told federal officials that due to the company’s “significantly high error rate (i.e., 30 percent of claims audited had errors),” the state would not automatically pay any bills submitted to Medicaid by Ultimate Nursing Services. The state would instead review 100 percent of the claims made by the company before any payments were made.

That was reassuring, but just a few weeks ago, federal officials announced that in the three years after DHS made that written promise, Ultimate Nursing Services continued to successfully bill Iowa’s Medicaid program for improper expenses - including, in some cases, travel and entertainment costs that federal authorities refuse to publicly disclose.

As a result, Ultimate Nursing Services and its president, Steven Tucker Anderson, have now agreed to pay $1 million to settle claims related to their Medicaid billings from January 2011 through June 2013.

Given all of that, you might think this company would no longer be allowed to bill Iowa Medicaid for home health services.

Alas, that’s not the case. The company remains a fully authorized provider of Medicaid-funded care.

Well, you might argue, that $1 million settlement probably covers all of the over-billings and includes a stiff penalty, too.

Wrong again. As part of the settlement agreement, Ultimate Nursing Services has stipulated to the fact that “the United States has a valid claim against Ultimate in the amount of $1,890,118.50.”

So, essentially, taxpayers are recovering 53 cents on the dollar, and in return for that payment, the federal government is letting the company continue to bill Medicaid.

This is like catching the bank robber, securing a confession, and then letting him keep half of the money while awarding him “Preferred Customer” status.

Sadly, this is not unusual. As The Des Moines Register has previously reported, companies sanctioned for defrauding the Medicaid program have a tendency to either remain in the program or, once booted, to worm their way back in as newly named, slightly reconfigured corporations.

In 2014, state officials alleged Kimberly Krum, the owner and founder of a Des Moines counseling agency called Families First, over-billed Medicaid to the tune of $1.9 million. A year later, the state agreed to settle the case by promising in writing not to pursue collection of the $1.9 million unless Krum launched a new agency and began billing Medicaid for services. The state also promised it would not seek any sanctions against Krum, pursue criminal charges or refer the case to any other agency for sanctions.

Then there was the case of Kenneth Cameron of Altoona. Four years ago, authorities alleged Cameron’s Des Moines counseling service, A New Beginning, had over-billed Medicaid $318,000 for behavioral health services. But Cameron never paid back the $318,000, and like Krum, he never faced any criminal charges. Instead, he shut down A New Beginning and launched a new counseling service he called Aspire. Through this new company, Cameron quickly obtained authorization to bill the state for behavioral health services through a program overseen by DHS itself.

Cameron’s attorney, Gary Dickey, told the Register it was a DHS lawyer who suggested this back-door method of having Cameron re-enter the Medicaid program as the head of a new company. “They told me to do that,” Dickey says. “They said it happens all the time.”

The moral of the story: If you want to get rich quick, and you don’t have any scruples, launch a health care company and start billing Medicaid for “services,” regardless of whether those services are real or imagined.

Even if you’re caught, you’re bound to come out ahead.

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Waterloo-Cedar Falls Courier. January 16, 2017

Bon voyage, Gov. Terry Branstad

The Courier’s Editorial Board on Friday had what will be, in all likelihood, its final meeting with Terry Branstad as governor of the state of Iowa.

The governor was warm and effusive. He’s eager to become U.S. ambassador to China. At the same time, he has a state budget and agenda he’s try to get off the launching pad until Lt. Gov. Kim Reynolds takes the helm and succeeds him.

His love for his current job is apparent. Though some would wish him good riddance, the people of Iowa have returned him time and again to Terrace Hill. He won every election. A succession of political rivals couldn’t blow him out of there with dynamite.

Many can take issue philosophically and in practice with his policies - and have. And continue to do so.

But we have seen over the years the governor is a man of character. We saw the best example of that when he campaigned to return to office in 2010, when he stood by one of the Cedar Valley’s own - former Lt. Gov Joy Corning of Cedar Falls.

Branstad was, and is, pro life. Corning is pro choice. She also was a board member of One Iowa, a group supporting same-sex marriage, while Branstad signed the Defense of Marriage Act, later struck down by the Iowa Supreme Court - a ruling The Courier has editorially supported in the past.

A shadowy “527” political organization with ties to a former state Democratic official tried to insert itself into the Republican primary and exacerbate division by noting Branstad “twice chose a pro-choice lieutenant governor,” Corning. Similarly, certain Republican social conservatives took the former governor to task for welcoming Corning’s support despite her position with One Iowa.

In a meeting with the Courier editorial board, Branstad stuck to his guns and stood by Corning.

“Look, I’m a social and fiscal conservative. But that doesn’t mean you don’t work with people,” he told us. “They want me to throw Joy Corning under the bus. I’m not going to throw Joy Corning under the bus.”

We appreciated his support then and now. Corning had a long record of public service as a Cedar Falls school board president, Iowa state senator from this area and as lieutenant governor. We know her and her late husband Burton’s contributions to the economic vitality and quality of life in the Cedar Valley.

Also, nothing could have been more pro-life or pro-family than Corning’s truly significant support of the Healthy and Well Kids in Iowa, or HAWK-I, health care program for underprivileged children. Branstad has taken similar child-friendly positions with his anti-bullying initiatives and promotion of multiple education initiatives, including science, technology, engineering and mathematics, or STEM.

We know political opponents will pose counterpoints and other reasons to criticize Branstad, maybe even despise him in the heat of political battle. Issues and philosophy are one thing. Character is another. Terry Branstad showed us, in his support for Joy Corning and in so many other ways, he has character and integrity.

We wish him well pending his Senate confirmation as ambassador to China, including safe travels, good health and every success as he represents our nation abroad.

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Sioux City Journal. January 19, 2017

Renewable fuel project at treatment plant holds promise

We share City Council enthusiasm for a proposed renewable fuel project at the city’s Wastewater Treatment Plant.

At its Jan. 9 meeting, council members voted unanimously to contract with a West Des Moines firm for engineering services related to the project, which will take two years to complete.

According to a Jan. 10 Journal story, the city will use the new system to capture, clean and compress gas created as a byproduct of the process used at the plant to convert raw sludge into biosolids. The gas will then be used or sold by the city as a renewable source of fuel.

“We’re not first in line for this, but we would be one of the few in Iowa or the region that would be doing this,” Mark Simms, the city’s utilities director, said in Ian Richardson’s story.

Simms said through sale of the gas, the $9.3 million project will pay for itself in two years.

We appreciate this project for several reasons: 1) It’s forward-looking. 2) It’s eco-friendly because it involves creation of a renewable fuel. 3) It will produce revenue for the city.

We understand some concern may exist within the community about this process because of the continuing dispute in South Sioux City over foul odors, tied to a renewable energy plant, in homes.

However, the Sioux City project is different because the Wastewater Treatment Plant has used its digester process to break down raw sludge since 1961 and the waste stream is confined to the plant. Unlike what happened in South Sioux City, none of the waste will be transported through sewer lines.

Although we acknowledge progress, we do share local concern about continuing odor problems at the city’s Wastewater Treatment Plant itself. Perhaps as the plant captures gas for this new project, it will capture a little more, if you know what we mean, because additional work is necessary on this front.

As for the renewable fuel proposal, though, our view is it’s an overall positive.

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Quad-City Times. January 20, 2017

Iowa needs a pay hike

Maybe counties shouldn’t have the authority to hike the local minimum wage. But any attempt in Iowa’s Legislature to strip that power without including a wage hike would fail local governments and workers alike.

Polk, Linn, Johnson and Wapello counties are in the midst of wage increases spread out over two years. In each case, the minimum hourly wage would spike from the state’s $7.25 minimum to north of $10. The state’s two most populated counties carry particular sway. And large employers are rightly concerned about a patchwork of varied wages making the act of doing business even more difficult and costly.

Gov. Terry Branstad has, too, publicly fretted about the effects such statewide variation would have on businesses with multiple locations. And the issue is now swirling around Des Moines as the Legislature eyes action under pressure from industry lobbyists to do something.

But it’s the threat of a half-measure that should most concern Iowans. It would be very easy - and, in many cases, politically expedient - for the Legislature’s dominant Republicans to leave the decade-old minimum in place, while stripping local governments of home rule.

Small government and local control are all well and good, for many Republicans, so long as they conform to a pre-approved political bent.

It wouldn’t just be a half-measure. It would be nothing short of ignoring calls by local governments - and their constituents - to boost a wage that, for years, hasn’t provided a living for thousands. It would be a shame when, in fact, now is the moment that Iowa could address the shortcoming in minimum wage policy by tying it directly to the rate of inflation.

There are a lot of myths circling about the minimum wage, well-worn talking points that simply defy fact. Most minimum wage earners are not “high school kids,” according the the U.S. Department of Labor. More than half of minimum wage earners are adults. Women and minorities are disproportionately represented. Some 89 percent of workers who would benefit from, say, a bump to $12 dollars are more than 20 years old, say federal data. Previous increases show that statements about the job-killing effects of a minimum wage increase tend to be overstated.

But, since it’s inception, minimum wage policy has been wracked by a fundamental flaw. Politicians go to war over it. The battle lasts for years. And, every year, those stuck at the minimum get poorer as inflation devalues the dollar.

It’s unclear what the right number is in Iowa. Johnson County landed at $10.10 an hour. Polk County workers would make a minimum of $10.25 in 2019, the county can actually enforce the local mandate. We fully admit, those figures might prove to exorbitant for a statewide minimum drafted for communities both rural and urban.